ADENOIDITIS

ADENOIDITIS 

WHAT IS ADENOIDITIS?

Adenoiditis is an inflammation of the adenoids.

Before going fully into what “Adenoiditis” are, let’s first refresh our memories on what “adenoids” are, which brings us to the question 👇🏾

WHAT ARE ADENOIDS?

Adenoids are a mass of tissue that, along with  tonsils, help keep a person healthy by trapping harmful germs that pass through the nose or mouth. 

Adenoids also produce antibodies to help the body fight infections. 

Unlike tonsils, which can be easily seen by opening the mouth,  we cannot see the adenoids. A doctor has to use a small mirror or special instrument with a light (called a zero degree telescope 🔭) to see the adenoids. Sometimes X-rays may be taken to see them more clearly. 

While adenoids play an important role in keeping a person healthy, as you get older, adenoids become less important, because the body is able to fight infection in other ways. In fact, adenoids often get smaller around age 5 or 6 and virtually disappear by the teen years. 

Along with the adenoids, tonsils are part of the lymphatic system. The lymphatic system helps to clear away infections and helps to keep body fluids balanced. Tonsils and adenoids works by trapping the germs coming in through the mouth and the nose. 

Now let’s discuss Adenoiditis proper.

Definition: Adenoiditis is defined as the inflammation of the adenoids . 

CAUSES OF ADENOIDITIS

1. Group A- beta streptococcus (which is the most organism associated with tonsillitis and adenoiditis).

2. Viruses such as EBV (Epstein-Barr Virus) associated with mononucleosis (the kissing disease).

3. Bacteria infections.

4. Auto-immune disorder.

5. Consumption of hot 🥵 food.

6. Unsafe coital habits.

7. Allergies.

8. Gastro-esophageal reflux.

9. Trauma

10. Witches and wizards .  

11. Village people.

PATHOPHYSIOLOGY OF ADENOIDITIS 

Adenoiditis is defined as the inflammation of the adenoids which may be acute or chronic, caused by microorganisms or trauma. 

When there is inflammation of the adenoids, it leads to migration of blood  cells to the affected part as a part of the inflammatory response.

As a result of inflammatory response there  is REDNESS and SWELLING of the adenoids.

Progressive inflammatory response leads to COMPRESSION OF NERVE ENDINGS manifesting as PAIN and DIFFICULTY IN SWALLOWING (dysphagia) leading to WEIGHT LOSS. 

     Due to compression of nerve ending the individual experiences HEADACHE. 

  Following the invasion of bacteria 🦠, there could be PUS FORMATION within the adenoids which will result in FOUL-SMELLING BREATHE (Halitosis).

Enlarged adenoids may cause MOUTH BREATHING, SNORING, EARACHE, DRAINING EARS, VOICE IMPAIRMENT and NOISY RESPIRATION. 

 Infection can extend to the middle ear by way of auditory (eustachian) tubes and may result in ACUTE OTITIS MEDIA.

If the causative agent finds its way into systemic circulation and gets to the brain 🧠, it results in FEVER 🤒, NAUSEA , VOMITING 🤮 and MALAISE . 

 

SIGNS AND SYMPTOMS OF ADENOIDITIS 

1. Sore throat 

2. Fever

3. Headache

4. Weight loss

5. Vomiting

6. Nausea

7. Malaise

8. Headache

9. Snoring

10. Halitosis

11. Voice impairment 

12. Difficulty swallowing  

13. Chronic ear infection (common in children)

14. Hearing loss

15. Nosebleeds

16. Cough

ASSESSMENT AND DIAGNOSTIC INVESTIGATION

1. PHYSICAL EXAMINATION: This is careful performed to rule out related or systemic conditions.

2. Throat swab for microscopy and culture sensitivity test.

3. Nasopharyngoscopy 

MEDICAL MANAGEMENT 

1. CHEMOTHERAPY: The choice of drugs is determined by the diagnostic investigation that is carried out on the patient. Appropriate antibiotics therapy is initiated for patients undergoing vADENOIDECTOMY. The most common anti-microbial agent used is ORAL PENICILLIN, Amoxicillin and erythromycin are alternatives. Also, If doctors think adenoids are enlarged because of allergies, they may give a nasal corticosteroid spray or other drugs, such as antihistamines, by mouth. If the cause appears to be a bacterial infection.

2. SURGERY : If these drugs are not effective or if doctors think they will not be useful, doctors may recommend surgical removal of the adenoids (called adenoidectomy).   Doctors may recommend adenoidectomy for children who have the following:

1.  Frequent ear infections and persistent collections of fluid in the middle ears

2.  Recurring nose bleeds or obstructions causing voice changes or disturbed sleep

3.  Sinus infections . 

Adenoidectomy does not seem to decrease the frequency or severity of colds or cough.

Although it requires general anesthesia, adenoidectomy usually can be done on an outpatient basis. Children typically recover from adenoidectomy in 2 to 3 days.

The following tips may help you feel better;

1. Drink cold liquids or suck on fruit-flavored frozen bars. 

2. Drink fluids and mostly warm (not hot), bland fluids.

3. Gargle with warm salt water.

4. Take over the counter (OTC) medications such as acetaminophen or ibuprofen to reduce pain and fever.

NURSING MANAGEMENT 

1. ASSESSMENT

2. ADMISSION

3. PHYSICAL CARE

4. HEALTH EDUCATION.  

NURSING DIAGNOSIS  

1. Acute pain related to irritation of the sensory nerves evidenced by restlessness.

2. Hyperthermia related to the alteration in the heat regulating center evidenced by thermometer 🌡 reading.

3. Imbalanced nutrition less than body requirement related to swelling of the adenoids ( difficulty in swallowing) evidenced by weight loss.

4. Impaired verbal communication related to physiologic changes secondary to infection or swelling evidenced by muteness.

5. Anxiety related to unknown outcome of prognosis evidenced by numerous questioning.

6. Deficient knowledge regarding prevention of infections, treatment regimen, surgical procedure or postoperative care evidenced by anxiety.